Consistent with the diversity of Latin America, there is profound variability in asthma burden among and within countries in this region. Regional variation in asthma prevalence is likely multifactorial and due to genetics, perinatal exposures, diet, obesity, tobacco use, indoor and outdoor pollutants, psychosocial stress, and microbial or parasitic infections. Similarly, nonuniform progress in asthma management leads to regional variability in disease morbidity. Future studies of distinct asthma phenotypes should follow up well-characterized Latin American subgroups and examine risk factors that are unique or common in Latin America (e.g. stress and violence, parasitic infections and use of biomass fuels for cooking). Because most Latin American countries share the same barriers to asthma management, concerted and multifaceted public health and research efforts are needed, including approaches to curtail tobacco use, campaigns to improve asthma treatment, broadening access to care and clinical trials of non-pharmacologic interventions (e.g. replacing biomass fuels with gas or electric stoves).

Background Obesity has been associated with higher risk of asthma and asthma severity, both in children and adults. However, studies evaluating the relation between obesity and rhinitis have yielded conflicting results. Methods We performed a cross-sectional study of obesity indicators and rhinitis using data from 8,165 participants in the 2005–2006 National Health and Nutrition Examination Survey. Allergic rhinitis was defined as physician-diagnosed hay fever or allergy, presence of symptoms in the past 12 months, and at least one positive allergen-specific IgE. Non-allergic rhinitis was defined as physician diagnosis and symptoms but no positive allergen-specific IgE. Multivariate regression was used to assess the relationship between obesity and rhinitis in children and adults. Results In adults, being overweight or obese was associated with increased odds of non-allergic rhinitis (adjusted odds ratio [aOR]=1.43, 95% confidence interval [CI]=1.06–1.93, P=0.02). Similarly, central obesity was associated with increased odds of non-allergic rhinitis in adults (aOR=1.61, 95% CI=1.20–2.16, P<0.01). In an analysis stratified by gender, the observed associations were attenuated and became non-statistically significant in female adults, but remained significant in male adults. Overweight, obesity or central obesity were not associated with allergic rhinitis in adults. In children, central obesity was associated with reduced odds of allergic rhinitis (aOR=0.35, 95% CI=0.19–0.64, P<0.01). After stratification by gender, this association was similar in female and male children. Conclusions In adults, obesity is associated with increased odds of non-allergic rhinitis, particularly in males. In children, central obesity is associated with reduced odds of allergic rhinitis, regardless of gender.

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